Several patients have recently presented with a medication history including tapentadol (Nucynta), the newest opioid formulation. It is approved for treatment of acute moderate-severe pain. Here are some key points:
Mechanism similar to tramadol: mu-receptor agonist, also inhibits norepinephrine reuptake
Potency stronger than tramadol, but less then morphine
Usual dose is same as tramadol 50-100 mg every 4-6 hours prn pain
Schedule II controlled substance, similar to morphine/oxycodone (tramadol is not a controlled substance)
Overdose should present like other opioids, but potentially also including tachycardia, serotonergic effects, and seizures (similar to tramadol)
